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July 20, 2011 07:47 PM UTC

Big news on the PPACA front - Free Birth Control!!!

  • by: DaftPunk

(PPACA stands for Patient Protection and Affordable Care Act — saved ya a Google, if you hadn’t heard the bill’s official name recently enough for the acronym to ring a bell. 🙂 – promoted by ProgressiveCowgirl)

Institute of Medicine report: Insurers should cover birth control as preventive care

One of the important aspects of healthcare reform is that preventive services must come at no out of pocket cost to the insured.  A $2 copay shouldn’t prevent you from getting your cholesterol checked or your mammogram. The political struggle is in what’s considered preventive.

It would seem obvious that contraception is preventive, but nothing stops the anti-contraception folks from raising a stink. To much anticipation, the Institute of Medicine issued their report, recommending such a designation.  


The recommendations went further than contraception though:

“This will cover current gaps in existing guidelines,” said Adam Sonfield, a senior public policy associate at the Guttmacher Institute. “This is going to have an important impact on health and well-being of women at all stages of their lives. This will level a playing field for women who cannot afford more expensive, longer lasting forms of contraceptives and allow for a choice of methods that works best for them. This will improve effective use of contraception and prevent unplanned pregnancies.”

The report also recommends complete insurance coverage – without co-pays – for lactation counseling and equipment, domestic violence screening and counseling, screening for gestational diabetes, human papillomavirus testing as part of cervical cancer screening for women over 30, counseling on sexually transmitted infections, and counseling and screening for HIV.

Critics chimed in with predictable arguments,

But abortion opponent groups argue the recommendations go too far and will violate the “conscience” of those providers, who for religious beliefs, oppose artificial forms of birth control. They argue consumers who do not wish to have their insurance plans include birth control, and emergency contraceptives will not have the choice to opt out. Finally, they say certain forms of emergency contraceptives have “chemically abortive properties.”

And supporters of the decision answered:

“Emergency contraception is not an abortion causing drug, it prevents fertilization,” said Dr. Vanessa Cullins, vice president for medical affairs at Planned Parenthood.

“This report, and the Patient Protection and Affordable Care Act, helps to move this country in a direction where we value prevention and not just acute care. And that is what we value at Planned Parenthood,”

The delegation from Rome had their say as well:

“Pregnancy is not a disease, and fertility is not a pathological condition to be suppressed,” said Deirdre A. McQuade, a spokeswoman for the (United States Conference of Catholic) bishops’ Pro-Life Secretariat. “But the Institute of Medicine report treats them as such.”

This decision, which must be formalized by HHS Secretary Sibelius putting it in the final regulations, represents a big win for those in the reality based community who work in sexual/reproductive healthcare.  For those who base their views in this area on the transcribed commands of the all-powerful sky daddy it’s a big poke in the eye.

It also goes at complete odds against the Republican view that healthcare should be a commodity governed by some sort of “free market” principals:

Sen. Richard Burr (R-N.C.) said he does not think there should be any “free” services provided by insurers, adding, “All of health care should have some out-of-pocket cost sharing. One reason why health care spending is at the level it is is because a lot of people perceive it to be free. That’s a utilization nightmare”

Clearly the partisan divide is aimed at two entirely opposite ways of controlling costs.  On the one hand we have the argument that the way to reduce healthcare costs is to reduce utilization by disincentivizing access, on the other the notion that lowering medical costs is best achieved with more up-front expense on preventive care.  We’ll see how things turn out.


20 thoughts on “Big news on the PPACA front – Free Birth Control!!!

  1. is that folks that are using them might be having a good time and the god who can do everything (including telling 2 folks to run against each other for the R nom for prez) can’t defeat a little pill

    1. From New Hampshire

      “I am opposed to abortion,” said Raymond Wieczorek, a council member who voted against the contract. “I am opposed to providing condoms to someone. If you want to have a party, have a party but don’t ask me to pay for it.”

  2. When women and men have the opportunity to delay or decline parenthood, it’s good for the economy, good for education, and good for communities. Very pleased to see this recommendation.  

    1. They have a dynamite combo public/private healthcare system with full terrific public coverage is the starting point  in a system with a full menu of private options too. Everybody loves it.  Many doctors work in public clinics in the morning and private practice in the afternoon. Makes ours look like crap in spite of costing us so much more.

      As for covering birth control here in the US?  I guess well over forty years late is better than never.

  3. Sen. Richard Burr (R-N.C.) said he does not think there should be any “free” services provided by insurers, adding, “All of health care should have some out-of-pocket cost sharing. One reason why health care spending is at the level it is is because a lot of people perceive it to be free. That’s a utilization nightmare”

    It probably has more free perks than mine, I’d wager.

    1. How about responsible people, including married couples, who don’t want to have more children than they can afford to raise?  You don’t want to pay for other people’s children’s needs.  They say if you can’t afford to have children have them and expect us to pay for their food and healthcare. You don’t want them to have abortions.  So what are they supposed to do without contraception?

      You don’t think people who can’t afford to have more kids should be able to have sex? Why do you hate love and pleasure so much, ArapG? Never mind.  I don’t think I want to hear it. From that party comment you agree with it’s pretty clear that guilt and shame have more to do with it than anything else.

    2. So tragedy of the commons is sort of out there.

      But in terms of harnessing the market forces to create more efficiency in the health care market, Mr. Burr is almost right.

      It’s not just the presence of cost share that creates more efficiency. It’s transparency in pricing. The presence or absence of a fee, or a larger fee, is only sufficient to ration supply, not increase efficiency.

      Consumption of health care is also different than most other goods and services, in that the perception of free does not motivate significant overconsumption.  If I could have an appendectomy surgery for free – I don’t get one, let alone two.

      By the way, in every major economy that has approached transparent pricing, some version of single payer has been adopted.  Can you guess why?  It costs less.

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